Polish healthcare systems, together with other European Union (EU) countries, must face the problem of rapid ageing of our societies. The increase in population of those aged 65+ will affect the average number of medications taken by patients due to their multimorbidities, longer lifespan and progress in pharmaceutical research
No official policy statements or regulatory guidelines on polypharmacy have been released to date by Italian Health Authorities. However, it should be acknowledged that the growing awareness of the problem has been documented by the release of observational studies on this issue by national study groups and scientific societies.
Portugal lacks any polypharmacy management program, and has no prospects for one in the near future. In addition to the lack of a polypharmacy programme, scientific literature also shows scarce concern for polypharmacy management and medication adherence in Portugal. The studies are limited to some hospital services or nursing homes, with few studies in primary care and ambulatory patients.
Germany has one of the world’s most rapidly ageing populations. The impact on health care provision will be enormous. Multiple chronic morbidities are common among older citizens and multiple medications are needed to keep people’s health under control. However, such polypharmacy poses serious health risks if inadequately applied.
The Spanish case study examined polypharmacy management in Catalonia. Two distinct models in different practice settings were identified: a government sponsored programme targeting complex chronic patients in primary care and an institutional network programme targeting older adults admitted to hospital, long-term care or nursing homes.
In 2012 the Swedish government introduced national legislation stating that all elderly patients using multiple medicines should receive medication reconciliation and, if necessary, a comprehensive medication review. This case study investigates how and why this legislation was developed and implemented on a national, regional and local level, with Uppsala County as the main example.
Scotland currently has a well-developed polypharmacy review programme, which is now in its fourth year. National Polypharmacy Guidance (2012, 2nd edition 2015) was developed by a multidisciplinary group and has been adopted by all 14 health boards (100%) across Scotland, with each board having developed plans to identify priority patients with potentially inappropriate elements to their polypharmacy and to implement reviews for those patients at highest risk of harm.